Frequency, time course, and possible causes of right ventricular systolic dysfunction after cardiac transplantation: A single center experience

Ronald Mastouri, Yasir Batres, Adam Lenet, Irmina Gradus-Pizlo, Jacqueline O'Donnell, Harvey Feigenbaum, Stephen G. Sawada

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: The frequency and causes of right ventricular (RV) systolic dysfunction early after cardiac transplantation are not well defined. Methods: We investigated the prevalence and causes of RV dysfunction in 27 heart transplant recipients, as measured by lateral tricuspid annular plane excursion (TAPSE) and fractional area change (FAC) at a mean of 15 ± 11 days after transplant. Tissue Doppler imaging was used to assess systolic time velocity integral (TVI) of the RV basal free wall. A subset of 22 patients had follow-up TAPSE measurement at 406 ± 121 days. Results: RV systolic dysfunction, defined as TAPSE > 2 standard deviation (SD) below values in a control group, was present in 100% (27/27) of patients (P < 0.05). FAC was also significantly lower in patients compared with controls (P < 0.0001). TVI confirmed the presence of RV dysfunction in all 16 patients with both TAPSE and TVI (P < 0.05). Ischemic time (P = 0.017) and posttransplant tricuspid regurgitation (P = 0.024) were independent predictors of early RV dysfunction (r = 0.753). On follow-up, RV function improved in 15 of 22 patients but all patients remained with TAPSE > 2 SD below controls. Conclusion: This study showed that 100% of patients had reduced RV function early after transplant. Two thirds of patients had partial recovery of RV function during the first year. In all patients, however, RV function remained significantly lower than in controls.

Original languageEnglish (US)
Pages (from-to)9-16
Number of pages8
JournalEchocardiography
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2013

Keywords

  • cardiac transplantation
  • right ventricle function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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